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Closing Gaps in Veterans' Care

Rush launches new Intensive Outpatient Program for veterans

Combat Vet gets care via the Warrior Care Network

By Charlie Jolie

The former service members who just arrived at Rush are among the estimated hundreds of thousands of U.S. military veterans whose service in the wars in Iraq and Afghanistan left them with lingering psychological scars. Like their fellow veterans, they’ve needed more extensive treatment than has been available. Now they’re receiving it.

This week, these veterans became the first to enroll in an innovative new Intensive Outpatient Program for post-traumatic stress disorder provided by the Road Home Program at Rush University Medical Center. The three-week, Monday through Friday, full-day regimen includes individual and group therapy, family education and counseling, psychiatric care, wellness and integrative medicine, and innovative therapies such as yoga and meditation.

The Intensive Outpatient Program plans to follow this first pilot with additional three-week sessions beginning Feb. 15, March 14 and April 11. The program currently is accepting patients for all three sessions. All participants in the program will receive treatment for PTSD, and the program also can provide treatment for traumatic brain injury, military sexual trauma and substance abuse as needed. The Road Home Program, also known as The National Center of Excellence for Veterans and their Families at Rush, provides its services, including the Intensive Outpatient Program, at no cost to the veterans and family members who receive them. For further information, please call the main number for the Road Home Program (312) 942-8387.

National network, integrated care

Road Home’s Intensive Outpatient Program — IOP for short — is part of the Warrior Care Network, a partnership announced last June between Wounded Warrior Project, a charity serving U.S. military veterans, Rush, and three other academic medical centers: Emory Healthcare, Massachusetts General Hospital, and UCLA Health. They also will be expanding programs providing intensive outpatient care for PTSD. In cooperation with the U.S. Department of Veterans Affairs, the Warrior Care Network has been established to fill in gaps in government-provided mental health care to reach veterans and family members who might otherwise go untreated. A national advertising campaign kicked off last week to inform veterans that this additional mental health care option is available. 

“The treatment program will integrate behavioral health care, rehabilitative medicine, wellness, nutrition, mindfulness training and family support,” says Mark Pollack, MD, the Grainger professor and chairperson of the Rush Department of Psychiatry. “Through this cutting-edge initiative, Wounded Warrior Project and its partners plan to serve thousands of wounded veterans and family members over the next three years.”

Wounded Warrior Project is supporting the network with grants totaling $100 million. Rush will receive $15 million through a three-year challenge grant from Wounded Warrior Project, which will make matching contributions of $2 for every dollar Rush secures for the Road Home Program, up to $2.5 million a year raised by Rush.

Filling a big gap

The Department of Veterans Affairs estimates that up to one in five of the 2.3 million American veterans who served in Iraq and Afghanistan will suffer from post-traumatic stress disorder at some point.  Many who seek treatment will attend an outpatient program or a longer-term day program at a VA facility, while a smaller number may have symptoms severe enough to require hospitalization. “That leaves a gap in services for some veterans,” says Thad Rydberg, social worker services manager at Road Home. “There are veterans whose PTSD can be treated in an intensive outpatient environment in order to help them make a healthy transition back to their lives as civilians.” For anxiety disorders such as post-traumatic stress, a patient’s progress in understanding and addressing its causes can stall between therapy sessions. Therefore, multiple consecutive days of therapy often can have a dramatic effect. 

Road Home clinicians and staff collaborate with local VA facilities in the Chicago area, and more than 300 veterans and family members have been treated at the Road Home Program since it was established at Rush in 2014 for a range of issues related to military service, including post-traumatic stress disorder, military sexual trauma and traumatic brain injury. Road Home also provides counseling for their children and other and family members.

Understanding trauma, calming the body

The IOP’s five consecutive days of treatment also allows clinicians to put into practice the growing body of clinical research in the biology of trauma-based disorders. While the mental and emotional trauma soldiers suffer has been observed for centuries, recent clinical research into these “invisible wounds of war” allows therapists to better understand the biological processes of trauma. The human nervous system has developed specific physiological actions — the fight or flight reaction — that help temporarily boost our physical and mental abilities either to escape or to contend with life-threatening situations. For people that suffer from PTSD, certain sounds, sights or smells act as sensory triggers that re-activate the fight or flight reaction. 

“For many vets, it could be the sound of a driving over a metal grid, or the sense of being surrounded by the high aisles in a supermarket” Rydberg explains. “Or any smell such as diesel fuel or of cooking food unique to the area where they served that elicits a feeling of panic or sense of danger.” The fundamental goal of treating PTSD is calming the body. Therapist-guided discussions, a treatment known as cognitive processing therapy, help patients better understand what has triggered a state of anxiety and thus helps them better control negative thoughts, while psychotropic drugs reduce anxiety by calming the body medicinally.

“But research is now providing evidence that yoga, meditation and other ‘mindfulness’ exercises have the same effect of calming the body,” Rydberg says. “We’re excited to integrate these techniques into the other approaches and provide these men and women a full spectrum of care.”  

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